MEDICARE: BERKELEY HEIGHTS TOWNSHIP BOARD OF EDUCATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1518679844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERKELEY HEIGHTS TOWNSHIP BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	345 PLAINFIELD AVE
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1480
Country	:	US
Telephone Number	:	908-464-1718
Fax Number	:	908-464-1728

Provider Business Practice Location Address
First Line	:	345 PLAINFIELD AVE
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1480
Country	:	US
Telephone Number	:	908-464-1718
Fax Number	:	908-464-1728

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	JULIE ANNE KOT
Credential	:
Telephone Number	:	908-464-1601

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	12/19/2022

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